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General NPI Number Information
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NPI Number | 1447348453
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Entity Type | Organization
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Legal Business Name | PFEFFER CHIROPRACTIC AND CONCUSSION CLINIC PA
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 108 15TH AVE E
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2510
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Country | US
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Telephone | 320-762-1110
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Fax | 320-762-2379
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Provider Business Mailing Address
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Address Line | 108 15TH AVE E
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2510
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Country | US
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Telephone | 320-762-1110
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Fax | 320-762-2379
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER PFEFFER
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Credential |
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Telephone | 320-762-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 003011
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License Number State | MN
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